Background and Objectives: Accurate breast tumor sizing is very important in treatment planning; as a result, ultrasound (US) plays an important role in diagnosing breast masses, due to its non-magnified image and its availability. The continuous change in the disease pathogenesis of breast cancer and tremendous advances in US imaging technology require the continuous evaluation of this imaging modality. In this study, our aim was to determine the accuracy of US in measuring the size of breast mass, and if there is an influence of the different pathological types on this accuracy. Materials and Methods: This study contained 66 specimens of breast masses that underwent surgical excision and pathological examination of the resected masses; the mean difference between the size taken by US and the size taken by pathology was calculated to the patients as a whole and for each tumor type in this study. Results: The result was that US underestimates the size of the tumor by 0.5 cm for all pathological types, and the US size is in agreement with the pathology size. Conclusions: US is an accurate method in measuring breast lesions with a degree of underestimation that may be related to many factors such as the tumor type, size, and margins. Complementary MRI is recommended in case of ILC and architectural distortion.

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Background: Relative hypovolemia may predispose to severe or prolonged hypotension after spinal anesthesia in patients undergoing orthopedic surgeries. Empirical administration of fluid preload is time consuming, costly and might lead to volume overload, especially in elderly patients. Therefore, predicting post spinal hypotension is of great importance to reserve fluid infusion for susceptible patients. Ultrasonographic evaluation of the internal jugular vein (IJV) diameter has been used to estimate intravascular volume in the ICU. Therefore, we investigated the efficacy of sonographic measurements of the internal jugular vein parameters for predicting post spinal hypotension in patients undergoing orthopedic surgeries. Methodology: The study was conducted on 62 patients scheduled for orthopedic surgeries. Sonographic measurements of IJV diameter and cross-sectional area were recorded at supine and Trendelenburg position before spinal anaesthesia. Blood pressure was monitored for 15 minutes for all patients and hypotension was documented. Results: Twenty-eight patients (45.2%) developed hypotension. The rate of increase in the diameter and cross-sectional area of the IJV with the change in patient’s posture was significantly higher in hypotensive patients. According to ROC curves analysis, a rate of increase of 12.36% in IJV diameter, and a rate of increase of 25.55% in IJV cross sectional area showed moderate specificity and sensitivity in the prediction of spinal hypotension. Conclusion: Preoperative sonographic measurements of the internal jugular vein diameter and crosssectional area at supine and Trendelenburg position can predict the occurrence of post-spinal hypotension.

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C OLORECTAL carcinoma is one of the most prevalent gastrointestinal malignancy, accurate staging is very important for proper treatment. Continuous advances in CT machines, change in disease process and its pathogenicity will change the accuracy of this modality and determine weather it can be relied on specially in local staging. The aim of this study is to evaluate the accuracy of Multidetector Computed Tomography (MDCT) in local staging of colorectal cancer by comparing it to operative findings and whether surgeons can depend on its results in planning surgery, also comparing CT and intraoperative results to pathology reports. Hence, the strength and weakness points of CT regarding macroscopic eye inspection can be evaluated and compared to microscopic pathology findings. Regarding the T-staging, CT accurately diagnosed 83 cases, while the intraoperative examination of the specimen diagnosed only 81 cases correctly, a difference which is not statistically significant, regarding N stage, the intraoperative examination was more accurate than the CT as it correctly diagnosed 61 cases while the CT diagnosed only 56 cases correctly, a difference which is also not statistically significant. It could be concluded that CT is an accurate method in staging, especially the stages III and IV, the accuracy is still not reliable in stage I and II. Regarding N-staging system, CT has a low accuracy regarding pathology, this accuracy increases if compared with operative data.